Affidavit Of Direct Payments
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Affidavit Of Direct Payments Form. This is a Texas form and can be use in Travis Local County.
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Tags: Affidavit Of Direct Payments, Texas Local County, Travis
TRAVIS COUNTY JUVENILE PROBATION
DOMESTIC RELATIONS OFFICE
ESTELA P. MEDINA
Chief Juvenile Probation Officer
SCOT M. DOYAL
Director
AFFIDAVIT OF DIRECT PAYMENTS
DECLARACIÓN DE PAGOS DIRECTOS
I, __________________, state that the following is a correct list of child support payments received from ___________
________. I further state that the payments listed below are not recorded on the official payment records of the County.
Texas Government Code § 559 gives you the right to review and request correction of information on this form.
Yo, _________________, declaro que la siguiente es una lista correcta de pagos de sostenimiento para niño recibidos de
____________________. Además, declaro que los pagos escritos abajo no están registrados en los archivos officiales de
pago del Condado.
Según el Código Gubernamental de Texas § 559 (Texas Government Code), usted tiene el derecho a reviser y
solicitor que se hagan correcciones necesarias a la información incluida en este formulario.
Date
(Fecha)
Amount
(Cantidad)
Date
(Fecha)
Cause #_____________
(Número de Causa)
Amount
(Cantidad)
Date
(Fecha)
Amount
(Cantidad)
Date
(Fecha)
Amount
(Cantidad)
Total of all direct payments:_____________
(Suma de todos los pagos directos)
____________________________
Signature (Firma)
STATE OF TEXAS
SUBSCRIBED AND SWORN TO BEFORE ME on this _________ day of ____________, __________.
__________________________________
Notary Public in and for the State of Texas
1010 LAVACA STREET
P.O. BOX 1495
AUSTIN, TEXAS 78767
PHONE: (512) 854-9696
FAX: (512) 854-9294
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